When looking at the sociological theories of stigma, much of the initial reaction to AIDS and AIDS- related illnesses can be understood. At the same time, such stigma and the phenomenon associated with can be used to explain some modern reactions to the disease and those who are afflicted with it.
In analyzing stigma, the ideas of social division that appear in Gerhard Falk's work are highly relevant. Falk argued that the need to establish power constructions are critical in understanding how social orders apply stigma to one group over another: "All societies will always stigmatize some conditions and some behaviors because doing so provides for group solidarity by delineating 'outsiders' from 'insiders." In this regard, one can see how those afflicted with AIDS experienced stigma in the 1970s and 1980s. In its initial social stages, AIDS was seen as a "gay disease," or something that applied only to people who were homosexual:
Throughout the 1980s, AIDS was closely linked to homosexuality in the minds of many Americans. This association can be traced to the syndrome’s initial epidemiology in the United States. AIDS was first identified in 1981, when clusters of gay men in Los Angeles and New York were diagnosed with Kaposi’s sarcoma and pneumocystis pneumonia. Early media reports referred to it variously as a gay disease, gay cancer, or gay plague, and some health care providers and researchers informally labeled it gay related immune deficiency (GRID),' reflecting an initial assumption that it struck only gay men.
In this understanding, Falk's ideas of social stigma can be seen. The establishment of heterosexuality as a trait of the "insider" was evident. The "outsiders" were those who were homosexual. The early social stigma affirmed this distinction. The idea of AIDS being something that reflected deviant behavior was reinforced by statements such as, "gay people whose lifestyle consists of anonymous sexual encounters are going to have to do some serious rethinking." Falk's "insider/ outsider" dynamic helped to explain the stigma around AIDS and victims of the disease, as evidenced in the teachings of religious leaders like Jerry Falwell:
AIDS is the wrath of a just God against homosexuals. To oppose it would be like an Israelite jumping in the Red Sea to save one of Pharaoh's charioteers. AIDS is not just God's punishment for homosexuals. It is God's punishment for the society that tolerates homosexuals.
Falk argues that "we and all societies will always stigmatize some condition and some behavior because doing so provides for group solidarity by delineating 'outsiders' from 'insiders." This helps to explain the stigma that AIDS patients and victims experienced.
Erving Goffman's analysis of stigma can reveal similar patterns of social acknowledgement. Goffman defines stigma as "The phenomenon whereby an individual with an attribute which is deeply discredited by his/her society is rejected as a result of the attribute. Stigma is a process by which the reaction of others spoils normal identity." The attributes that the stigmatized individual possesses is what makes them fundamentally different, and thus victimized:
While a stranger is present before us, evidence can arise of his possessing an attribute that makes him different from others in the category of persons available for him to be, and of a less desirable kind--in the extreme, a person who is quite thoroughly bad, or dangerous, or weak. He is thus reduced in our minds from a whole and usual person to a tainted, discounted one. Such an attribute is a stigma, especially when its discrediting effect is very extensive [...] It constitutes a special discrepancy between virtual and actual social identity.
The physical traits of AIDS patients helped to reinforce this idea of "attributes" possessing a "discrediting effect." The lesions that were the "mark" of Kaposi’s sarcoma along with pneumocystis pneumonia helped to establish physical attributes that were stigmatized in social perception. The physical condition of AIDS helped to reinforce the "tainted" aspect of social stigma. In this understanding, physical attributes helped to "mark" the outsider. Goffman's analysis and Falk's analysis of stigma help to explain the ferocity of the initial reaction to AIDS patients and the disease itself.
We have come a long way from the initial social reaction that was a significant part of the AIDS narrative. For the most part, it is established face that AIDS is not something intrinsic to one group of people. However, the reality is that stigma still lingers when it comes to people who are HIV positive or live with AIDS. UN Secretary-General Ban Ki Moon argues that stigma still exists, and in his words, one sees the same experiences of stigma that thinkers like Falk and Goffman articulated:
Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.
The UN Secretary General's words are powerful in demonstrating that stigma lingers today in a similar form as it did in the early 1980s and late 1970s. The denial of voice is still an active part of the stigma process for those with HIV and AIDS.